Provider Demographics
NPI:1871844886
Name:KEARNS, LAURA ASHLEY (AUD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ASHLEY
Last Name:KEARNS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ASHLEY
Other - Last Name:BRANSCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:4004 DUPONT CIR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4819
Mailing Address - Country:US
Mailing Address - Phone:502-893-0159
Mailing Address - Fax:502-213-3853
Practice Address - Street 1:4004 DUPONT CIR
Practice Address - Street 2:SUITE 220
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4819
Practice Address - Country:US
Practice Address - Phone:502-893-0159
Practice Address - Fax:502-213-3853
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100028231H00000X
KY0557231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0169Medicare PIN